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The 2011 Report

to the Secretary:

Rural Health and

Human Services Issues

NACRHHS

The National Advisory Committee on

Rural Health and Human Services

March 2011

Acknowledgements

The 2011 Report to the Secretary is the culmination of a year of collective effort by the National Advisory Committee on

Rural Health and Human Services (NACRHHS). This effort was led by former Chairman David Beasley, who stepped

down in June of 2010. I would like to thank each of the Committee members for their hard work and acknowledge the

subcommittee chairs of each of the three chapters: Graham Adams, Rural Implications of Accountable Care Organizations

and Payment Bundling; David Hartley, Rural Childhood Obesity; and April Bender, Place-Based Initiatives for Rural Early

Childhood Development. Laura Merritt, Kai Smith, CJ Koozer, and Tish Scolnik, Truman Fellows with the Office of

Rural Health Policy (ORHP) at the Health Resources and Services Administration (HRSA), provided research support and

assistance in drafting key sections of the final report. Beth Blevins edited the report.

The Committee also benefited from the hospitality and rich information provided by various individuals connected with

the Committee’s two field meetings in 2010. The opportunity for the Committee to learn about rural health and human

services delivery in the field from those who are actually providing the services was critical in creating this report and the

recommendations that are included. More information on these meetings and site visits is provided in the appendices. The

number of people who helped to make the field meetings possible is far too many to list here, but I want to acknowledge

the help of a few individuals.

In June, the Committee visited the South Carolina Lowcountry where they heard testimony from health and human services

providers in the surrounding communities. NAC Member Graham Adams assisted in planning the meeting and Dr. Amy

Martin provided further support. The South Carolina meeting featured important presentations by a number of individuals

including Jan Probst of the South Carolina Rural Health Research Center, Michael Byrd of the South Carolina Department

of Health and Environmental Control, Francis Rushton of the American Academy of Pediatrics, Mary Lynne Diggs of the

South Carolina Head Start Collaboration Office, Ed Sellers from BlueCross BlueShield of South Carolina, and Robby

Kerr, formerly of the South Carolina Department of Health and Human Services. Committee member Sharon Hansen also

presented.

In September, the Committee visited Eastern Iowa. Todd Linden, NAC Member and CEO of Grinnell Regional Medical

Center played a key role in coordinating the meeting. Further meeting support was provided by NAC Members Donna

Harvey and Maggie Tinsman. In addition, the Committee benefited from site visits hosted by Gloria Vermie of the Iowa State

Office of Rural Health. The Committee benefited from presentations at the September meeting from Julie McMahon of the

Iowa Department of Public Health; Deborah Waldron of Child Health Specialty Clinics; Linda Snetselaar of the University

of Iowa College of Public Health; Bill Menner, Iowa’s state director of USDA Rural Development; Keith Mueller of the

Rural Policy Research Institute and University of Iowa College of Public Health; David Swieskowski of Mercy Clinics;

former Iowa State Senator Charles Bruner, of the Child and Family Policy Center; and Shanell Wagler of Early Childhood

Iowa.

The report benefited from the assistance of Federal staff from ORHP, including Tom Morris, Heather Dimeris, Carrie

Cochran, and Jennifer Chang as well as Dennis Dudley from the Administration on Aging.

The Committee is grateful to many others, too numerous to mention, for their support of the Committee’s mission to inform

and make recommendations to the Secretary and others on the state of health and human services in rural America.

Sincerely,

The Honorable Ronnie Musgrove, Chair

About the Committee

The National Advisory Committee on Rural Health and Human Services (NACRHHS) is a citizens’ panel of nationally

recognized rural health and human services experts. The Committee, chaired by former Mississippi Governor Ronnie

Musgrove, was chartered in 1987 to advise the Secretary of the U.S. Department of Health and Human Services (HHS) on

ways to address health problems in rural America. In 2002, the Committee’s mandate was expanded to include rural human

services issues and a 21-member limit was set.

The Committee’s private and public-sector members reflect wide-ranging, first-hand experience with rural issues, including

medicine, nursing, administration, finance, law, research, business, public health, aging, welfare, and human services.

Members include rural health professionals as well as representatives of State government, provider associations, and other

rural interest groups.

Each year, the Committee highlights key health and human services issues affecting rural communities. Background

documents are prepared for the Committee by both staff and contractors to help inform members on the issues. The Committee

then produces a report with recommendations on those issues for the Secretary by the end of the year. The Committee also

sends letters to the Secretary after each meeting. The letters serve as a vehicle for the Committee to raise other issues with

the Secretary separate and apart from the report process.

The Committee meets three times a year. The first meeting is held during the winter in Washington, D.C. The Committee then

meets twice in the field, in June and September. The Washington meeting serves as a starting point for setting the Committee’s

agenda for the coming year. The field meetings include rural site visits and presentations by the host community, with some

time devoted to ongoing work on the yearly topics. The Committee is staffed by the Office of Rural Health Policy, located

within the Health Resources and Services Administration at HHS. Additional staff support is provided by the Administration

on Aging at HHS.